Wall Street Journal - December 20, 2001
Robert Block, Staff Reporter of The Wall Street Journal

JOHANNESBURG, South Africa -- In a move likely to raise new concerns over South Africa's AIDS policy, the government announced that it would appeal a court ruling compelling it to provide antiretroviral drugs to pregnant women infected with the virus that causes AIDS.

"We have instructed our legal counsel to appeal the judgment to the Constitutional Court as soon as practicable," Health Minister Manto Tshabalala-Msimang said in a statement.

On Friday, ruling in a lawsuit brought by pediatricians and AIDS activists, High Court Judge Chris Botha had ordered the government to plan an effective comprehensive national program to prevent or reduce the mother-to-child transmission of HIV, including providing the drug nevirapine or other appropriate medicine.

The Treatment Action Campaign, an AIDS activist group, had filed the suit, arguing that the government's policy of providing nevirapine at only 18 pilot sites discriminates against women who give birth at other hospitals.

The court rejected government claims that nevirapine was unproved and that it would be impractical to administer it to women without drastically improving the quality of care available at state-run hospitals.

In her statement, Ms. Tshabalala-Msimang said the appeal did not mean that the government wouldn't be pursuing a dynamic program to prevent mother-to-child transmission of HIV. She said the health department would be reviewing results from the pilot projects next month and evaluating its program for pregnant women infected with HIV.

About one million babies are born in South Africa every year, and 25% of their mothers are HIV-positive; 70,000 of the babies contract the virus, either during pregnancy or at birth. A dose of nevirapine syrup given to the baby within 72 hours after birth can cut infection rates by half.

Ms. Tshabalala-Msimang said the appeal was unavoidable, because the court ruling challenged the country's constitution and raised questions about what role the courts in South Africa have to direct government policies.

Mark Heywood, national secretary of the Treatment Action Campaign, said the government's stance was "callous" and would be a "political and public relations disaster."

Pretoria has come under widespread criticism for its controversial AIDS policies. President Thabo Mbeki has stirred international furor by questioning whether HIV causes AIDS and by challenging infection rates reported by his own government. Boehringer Ingelheim GmbH of Germany, which makes nevirapine, has offered to provide it free of charge, but Mr. Mbeki has been reluctant to subsidize AIDS treatment, citing the risk of side effects.

Write to Robert Block at bobby.block@wsj.com

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